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What's "REASONABLE" when the system(S) to address Neuro-developmental & Psychiatric Disorders are already OVERWHELMED & RElying on A scientifically invalid DSM

2/22/2024

Val's Take/Conjecture

"University Teaching Hospitals" are an important connection between RESEARCHERS and CLINICIANS.

One of the scariest things to observe in Mental Health is the LARGE DIVIDE that has grown up between the RESEARCHERS and the CLINICIANS.

Generative AI in Healthcare

Is this an Olmstead Issue?

So Olmstead is about preventing the unnecessary institutionalization of people with disabilities.

Further, it is currently understood to include the risk of institutionalization of people with disabilities that is inherent in HOMELESSNESS.

OVER10 Years After the National Institute of Mental Health Called Out the DSM 5 --- Where Are We?

NIMH's idea which sounded good at the time and probably is still good in many respects was the RDoC Program.
- The DSM was not tied to the underlying biology BUT
- The RDoC Program and its "MATRIX" would be.

In the intervening 10 years, we've learned a lot more and seen the emergence of:

The Microbiome
Immuno-Psychiatry
Metabolic Psychiatry
Neuro-Endocrine Psychiatry
Maternal Immune Activation
A Neuro-Developmental-Psychiatric Continuum

The number of variables is staggering.

I do think we are reaching our limits to process information. There is a need to expand those limits to achieve more effective individualized medicine.

AND

The largest institutions for people with mental illness are JAILS & PRISONS.

Even if we don't readily have available the absolute answer --- If we had a mental health profession that was MORE AWARE of its knowledge limitations ---

we might have the INTELLECTUAL MATURITY to get more people out of jails and prisons.
and provide the ALTERNATIVES currently necessary.

Insanity

Science Up

Denver Mayor Johnston's numeric goals, SUPPORTIVE HOUSING and the state

2/16/2024

Val's Take

Olmstead Plans need Reasonable, Measurable, and Numeric Goals.
- If you don't have that --- that is one of the first tip offs that you don't have a legally compliant OLMSTEAD PLAN.
- COLORADO DOES NOT HAVE A FEDERALLY COMPLIANT OLMSTEAD PLAN and MOST STATES DON'T.
  - It appears Minnesota's Olmstead Plan has Numeric, Measurable Goals --- after Federal Judge Donovan Frank threw more than one hissy fit.

Johnston is a mayor, a former legislator --- he's largely focused on the most pressing problems and set Numeric Goals and gone from there.It hasn't always been pretty--- but things don't seem STUCK in ANALYSIS/PARALYSIS.

The grand OLMSTEAD Soviet-Style Plan hasn't really worked over the past 20 years since Olmstead was decided.States by and large are OVERWHELMED with the MAGNITUDE of the ISSUES ---

States try to stay as VAGUE as possible so they are NOT ACCOUNTABLE
& Generally do "some good things."

The Disability Community often doesn't feel like it can look Olmstead --- this gift horse --- too closely in the mouth --- and the US Department of Justice files "some cases" (including in Colorado) ---

BUT WIDESPREAD NON-COMPLIANCE IS THE NORM.

We need STATE NUMERIC YEARLY GOALS for SUPPORTIVE HOUSING

I think the State needs an "Objective Measure" for that --- Medicaid Long Term Care might be such a measure.
Further, partnering with municipalities probably makes a lot of sense.
Further, there are various funding streams this could come out of.

What's "REASONABLE" when the system(S) to address Neuro-developmental & Psychiatric Disorders are already OVERWHELMED & RElying on A scientifically invalid DSM

Denver Mayor Johnston's numeric goals, SUPPORTIVE HOUSING and the state

Olmstead Law & Order Thursday

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